Lately the mainstream media has picked up on the discussion
that has been raised regarding the changes in how depression and bereavement
are going to be designated in the revised edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM).
This manual and its revisions, have been published since 1994 by the
American Psychiatric Association and is used by all mental health professional
in the United States to categorize and diagnose mental health disorders in
adults and children.
What has caught the attention of professionals and
lay-people alike is the changes that are being made in the categorization of
depression. In the current edition of
the DSM, bereavement has been carved out as a separate category from a Major
Depressive Episode. The guideline states that diagnosis of Major depressive
Disorder would not be given until the symptoms had been experienced for at
least 2 months after the loss. Symptoms
include: feelings of sadness, insomnia, poor appetite, and weight loss. The DSM
differentiates between normal grief and a Major Depressive Episode by advising
the professional to look for subtle differences in symptom presentation.
The removal of the bereavement category was explained by the
American Psychiatric Association in a news release of 12/1/12 that stated:
Removal of bereavement exclusion: the exclusion criterion in
DSM-IV applied to people experiencing depressive symptoms lasting less than two
months following the death of a loved one has been removed and replaced by
several notes within the text delineating the differences between grief and
depression. This reflects the recognition that bereavement is a severe
psychosocial stressor that can precipitate a major depressive episode beginning
soon after the loss of a loved one.
"Grief is an equal opportunity human reaction; grief
affects everyone." explained J. Shep Jeffreys in his book
"Helping Grieving People: When Tears Are Not Enough." This is an accurate statement. Everyone will eventually experience
bereavement if they live long enough.
However each person reacts differently to the stressors of grief and
just as with physical illness some people will be resilient and able to bounce
back while others may have a more difficult time and may need support and
treatment. The thing is to not spend so
much time debating whether this change is "pathologizing" grief but
to spend the time helping those who need it.
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